The Association between Anemia, Hepcidin and Vitamin D Levels in Preterm Infants

Introduction: Premature infants are vulnerable to iron imbalance. Hepcidin is a regulator of iron homeostasis and is inversely correlated with vitamin D status. We aimed to investigate the association between anemia, hepcidin and vitamin D in anemic premature infants, a relationship which might reflect a possible therapeutic potential of vitamin D supplementation in this population.

Methods: Preterm infants born before 36 weeks of gestation were prospectively recruited at “Lys Neonatal Intensive Care Unit”. Blood samples for hepcidin, iron, ferritin, complete blood count, C-reactive protein (CRP) and 25-OHD were collected. Anemia was defined as hemoglobin level 2 standard deviations below mean for age, and non-anemic controls were matched according to week of life at the time of sampling.

Results: Seventy-five preterm infants were recruited and Forty-seven were included in the final analysis. Only 7 infants (14.8%) had anemia. Serum hepcidin levels were significantly higher in anemic preterm infants compared to controls (55.26 vs. 29.8 ng/mL, respectively) (p<0.05). Hepcidin levels were higher during the first two weeks of life. Iron levels did not differ between the groups. A positive correlation was found between hepcidin and ferritin (p<0.05). CRP was within normal range in all participants. No associations were found with vitamin D levels.

Conclusion: Our study suggests that vitamin D is not associated with anemia of prematurity. It remains to be investigated the mechanism underlying anemia and the role of high levels of hepcidin in premature infants.